Find out how the availability of breakthrough cancer drugs work

Generally cancer treatment is the same whether you go privately or through the NHS. Although you may be able to access some scans and treatments more quickly as a private patient, the NHS has a fantastic reputation for the quality of it’s cancer care. All across the world the NHS is viewed as a trailblazing organisation at the forefront of medical practices.

Despite this, one area the NHS may fall short is with regards to the availability of breakthrough drugs. In the recent past many patients could only access breakthrough drugs privately if their local authority was willing to put the necessary funding in place. This led to a “postcode lottery” situation in some parts of the country, with some areas willing to pay the price to fund expensive new drugs, while other regions preferred to use their budget for other purposes.

These issues led to the formation of the National Institute for Clinical Excellence (NICE) in an effort to harmonise drug availability across the UK. Under current UK law if NICE approve a new treatment or drug, all heath authorities have to provide it. While this reformed system is a huge improvement over the old one, offering a greater degree of equality for all, NICE can still refuse to make some drugs freely available on the NHS.

When deciding whether or not to make a drug or treatment freely available, NICE consider the following factors:

  • Supporting evidence surrounding the need for a new drug or treatment.
  • Clinical trial data to assess the effectiveness of the drug itself.
  • Assessment of whether the drug is cost effective for widespread use.
The average wait between a drug becoming available and NICE approving it for use was around 5 years.

Deciding whether or not to approve the availability of a drug on the NHS isn’t a decision to be taken lightly. Often new drugs and treatments are prohibitively expensive and simple financial considerations dictate that the widespread availability of a drug is infeasible. Also, often NICE will wait until there is firm evidence from clinical trials before making a decision. So a drug may be available for a private trial many months or years before it comes available on the NHS. Recently a study revealed the average wait between a drug becoming available and NICE approving it for use was around 5 years.

In an effort to combat this problem the UK government launched the Cancer Drugs Fund. The aim of the fund is to help patients access drugs which haven’t yet been approved by NICE. The fund contains around £200 million which patients can apply to use for currently unavailable cancer drugs. All applications are considered on an individual basis, and whether an individual is approved may depend on the type and stage of their cancer. Often applications are only approved for patients who have good odds of responding well to the treatment.

Controversial drugs unavailable on the NHS

  • Avastin Avastin is a drug designed for breast cancer cases. It works by starving blood to tumour sites and is primarily used for patients who have developed secondary tumours. The drug is not routinely available on the NHS after NICE ruled it does not offer value for money.

    Although Avastin is unavailable on the NHS, patients with private medical insurance policies are routinely covered for it’s use. As the drug is designed for women with advanced breast cancer, these women often have limited treatment options and many clinicians rely on Avastin to prolong their patients life.

  • Abiraterone Abiraterone has been hailed as a break through testicular cancer drug. It is designed to extend the lives of men with advanced prostate cancer. However, for each extended life year the drug is estimated to cost £63,200, so for financial reasons alone the NHS can’t afford to approve it. If you’re fortunate enough to have private medical insurance Abiraterone may be available, but that doesn’t help the 5000 men with advances prostate cancer who need the drug now.

In cases like this having a private medical insurance policy could quite literally save your life, and allow you speedy access to the drugs and treatment your specialist recommends. It’s clear that more needs to be done to reduce the initial cost of new drugs so they are accessible to all.

From 2014 the government plan to introduce a new method of setting the price for cancer drugs. It is hoped that one this programme is implemented many drugs which were previously unavailable on the NHS will receive NICE approval.

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